Provider Demographics
NPI:1609941681
Name:BIRDSEY, ALISON (CNM)
Entity Type:Individual
Prefix:MS
First Name:ALISON
Middle Name:
Last Name:BIRDSEY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:
Other - Last Name:BIRDSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:TRIDER
Mailing Address - Street 1:499 FARMINGTON
Mailing Address - Street 2:SUITE 220
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032
Mailing Address - Country:US
Mailing Address - Phone:860-676-8111
Mailing Address - Fax:
Practice Address - Street 1:499 FARMINGTON AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032
Practice Address - Country:US
Practice Address - Phone:860-676-8111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001727363LW0102X
CT000232367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT009002323Medicaid
CTD400002500 - C00023Medicare PIN
CTD400002501- C00814Medicare PIN
CT009002323Medicaid
CTS80751Medicare UPIN